ADHD and OCD

Sally felt really proud of herself. For years she felt like her house was looking like a disaster area. Every surface was piled high with papers, shopping bags, paper work and flyers were mixed with important tax documents.

Her floors had abandoned clothes and half empty boxes from her last move, which was 3 years ago. She was so embarrassed that she never invited friends over.

Then one evening, Sally got frustrated because she couldn’t find a spoon to cook her stir fry. So, she decluttered her spoon drawer. It felt so good to have a tidy drawer that over the next year Sally decluttered and tidied every drawer, shelf, counter top and floor space.

Now when Sally opens a cupboard, each item is arranged neatly. It is easy to find things, and Sally feels calm, focused and happy.

At first Sally was thrilled to be able to invite friends over. But then she started to get confused because friends would say things like,

‘You don’t have ADHD, you have OCD,’

and Sally started to question if she had ADHD after all.

Sally’s friends’ reaction is common for people who only know a little about ADHD. People image that someone with ADHD would have a cluttered disorganized home, (like the old Sally) while someone with OCD lives in an organized place.

The problem with comments like these is that ADHDers start to question their diagnosis…just like Sally did.

If you are a little confused about the difference between OCD and ADHD, here are some facts.

What is OCD?

Obsessive-compulsive disorder (OCD) is an anxiety disorder that results in obsessive thoughts and compulsive behaviors. These thoughts and behaviors are experienced to such an extent that they get in the way of daily living.

People with OCD often belong to one of these groups:

Checkers

Checkers continually check things associated with possible danger. They check to see if the door is locked or if the stove is switched off.

Hoarders

Hoarders and collectors keep unnecessary items. They don’t throw things away because they fear something bad will happen if they do.

Washers

Washers are fearful of contamination. They have obsessions with cleaning or hand-washing.

Counters

Sinners

Sinners fear that if everything isn’t just so, they will be punished.

People with OCD often have ‘magical thinking’. They think if everything is perfect, nothing bad will happen. They perform their ritual; it offers a moment of mental peace before the obsessive thoughts start again.

When ADHD can look like OCD

ADHDers might act in a way that, on the surface, looks like OCD. However, they have developed these behaviors to help themselves to function in the world, instead of the constant obsessive thoughts that drive a person with OCD.

Here are some examples.

Before leaving their home, a person with ADHD might run around checking that all windows and doors are shut and locked before they leave. Habits like these aid poor memory (which ADHDers are prone to) and have been developed to avoid any unpleasant surprises.

In contrast, someone with OCD is probably already certain that everything is secure but are checking to satisfy an obsessive urge.

ADHDers who create and maintain an organized environment enjoy the sense of emotional peace that a clear space gives them. They feel more focused, less scattered. It’s a way for them to control the negative effects of ADHD rather than an obsession.

ADHDers often have a lot of clutter; but rather than being hoarders, it’s because decluttering is boring and involves attention to detail to keep clutter at bay.

Similarities of ADHD and OCD

Both ADHD and OCD are highly genetic and result in reduced attention, poor memory and impulse control.

Differences

One difference between ADHD and OCD is chemical. ADHD is in part due to low dopamine levels in the brain and OCD is due in part to low serotonin in the brain.

The medications prescribed for the 2 conditions are different too. Stimulant meds, like Ritalin, that are prescribed for ADHD aren’t effective for OCD. SSRI anti-depressant meds prescribed for OCD aren’t usually helpful for ADHD symptoms although they might be prescribed if there is a co-exsisitng condition of depression.

ADHD and OCD are very different, and people can have both ADHD and OCD. In fact, if you have ADHD, you have a higher chance of also having OCD than someone without ADHD.

However, if you have either OCD or ADHD or both: Don’t panic! Both can be treated and managed.

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Comments

I had an ‘unofficial’ ADHD diagnosis whilst at university 4 years ago at the age of 45. The diagnosis didn’t come as a total surprise. It was suggested that both my sons had ADHD when they were at school. They are now in their 20s.
I have a diagnostic report from university. I’ve since researched the condition, extensively, for the last 4 years. I have my school reports which highly suggest ADHD, as do my sons. I have a sleep disorder, “anxiety”, impulsively, failed relationships, low self esteem, underachiever, a very long work history. I am a nomad! I can fall asleep after a coffee. I failed the ‘marshmellow test’ in a way that only someone with ADHD could! I was also diagnosed with Myers Irlan.
I DO NOT question that I have ADHD!!
After many visits to my GP, and after concerns from my employer, I finally got refered to a consultant psychiatrist. Who just happened not to be an ADHD specialist.
To cut a long story short, he diagnosed me with OCPD. He thinks I have a personality disorder!
I do not meet the criteria for OCPD – we are polar opposites! He picked up on a few things I said, one being I like to keep my house tidy, and ran with it, in the totally wrong direction! If my home gets too cluttered, so does my brain and then I get overwhelmed!
I kept interrupting him. I apologised. He asked me “by the way, why do you keep doing that?”
He had no understanding whatsoever of ADHD, consequently, I will not be referred onto an ADHD specialist out of county. So no proper, or fair diagnosis, support or treatment.
It’s very frustrating, but this is the battle we have in the UK.
I could challenge his diagnosis, I could ‘rip it apart!’, but I can’t motivate myself to log into my laptop and start typing! Just yet, plus I don’t know if it’s worth the fight. It could take 2 years to get refered to a specialist…it all comes down to money!!
Untappedbrilliance has been a lifeline. Thank You.

Hi Jen, I definitely feel you, there are a lot of dodgy psychiatrists out there. I think that diagnosis are definitely based on the interpretation of psychiatrist… therefore it is an art not a science. I would definitely try and see a different psychiatrist to then get a referral to the adhd specialist. The DSM (diagnosis manual) gets changed every few years based on clinicians changing there minds about where symptoms fit and and what different conditions are, so definately and art… especially when they are making a diagnosis from one assessment! I think as you know yourself better than the psychiatrist, that he should be doing his best to listen to you and your explanation about why you think something is happening. Abit of a worry that he didn’t understand you were probably trying to clarify/ correct something when you were interupting. Not sure what the mental health system in England is like, but in Australia it is terrible and I have heard horror stories of peoples lives being negatively effected by medication/ treatment from wrong medication. So trust your gut and look after yourself 🙂 goodluck! P.S your GP may be able to give a referral to an adhd specialist? Or there might be some NFP’s around for adhd that could assist you in getting a diagnosis, or point you in the right direction 🙂

I always thought I had OCD/OCPD as I would be teased constantly about my desire to have things organized and the fact I seemed to lack the ability to be spontaneous. It was a running joke with my friends all while growing up and into my early adult years. I was a very anxious child which grew up to be an anxious adult.

I was raised in a home environment where things needed to be just so and my mom was always on top of cleaning and organizing. I learned that cleanliness and organization can relieve anxiety and help to make sure things run smoothly. In retrospect, having this kind of home life probably masked my ADHD. I didn’t forget things as there was always the proper place for them. I could not procrastinate too much as my parents made sure that school work was done before we were allowed to go out and hang with our friends, watch tv, or play video games.

When I moved out from parents home I took these same principles with me and tried to replicate them with my boyfriend when we moved in together. He could not understand why I had to have things just so or what my obsession was with organizing things was all about( I had binders of lists I had created for EVERYTHING!!). I couldn’t explain it either. All I knew was that I had less anxiety when I could find things and when clutter was managed. He was not at all like this(despite having military training ) and so every attempt I had made to keep things just so was met with opposition. The more anxiety the situation caused the more I needed to organize things but also the more they fell apart as I did not have the support from my partner. I could not manage the household like I was able to when I lived at home and had the right kind of healthy accountability set up with my parents. Additionally, my partner had been in a horrible car accident where he sustained some head trauma and also suffered from extreme mood swings due to a mental illness. The only way I could deal with any of these chaotic things was to try and control my environment even more which did not work as my ADHD self was starting to make its presence known. I thought I was going crazy. One hand was trying to organize and control and the other hand just wanted to play video games all day. If I let the ADHD brain win then nothing got done and my partner was mad, if I let the OCD side take over then I still ticked off my partner as he hated the rigidity and the seemingly irrational way I organized things.

Fast forward 14 years to when I was on my own after the separation from my partner and living as a single parent. I had no external accountability anymore, no parents and no partner. I fell apart. I could not keep things together, I floundered with organizing. Carefully made meal plans never got used. We ate a lot of take out! My dishes pilled up for weeks sometimes. Piles of laundry, papers, and books lay everywhere. I managed to keep on top of my bills thank goodness but keeping up with my daughter’s school needs was horrendous. I then realized what the issue was (my ADHD) and I cut myself some slack. I know now that having an organized home, schedules, and accountability are things that help me thrive. It does not mean I have OCD/OCPD. I never felt the compulsion involved with having that condition and so I knew that was not the issue. I have put into place several systems that help with my ADHD although sometimes they do get changed up when I get bored of them. Accountability is still my Achilles heel but it is easier to deal with now that I know about it. I also have done A LOT of work on my anxiety issues and feel I am in a better place with it.

It is good to know though that many fellow ADHDers also experience OCD/OCPD like symptoms and experiences and that it can be a further issue to contend with.

As a side note, I was placed on Citalopram to help deal with my Anxiety and all it did was make me tired. I felt slow and had issues with brain fogginess and memory recall that I think was an indicator that my issues were not with serotonin. I am no longer on that medication and I feel much better in many ways. I am not medicated with my ADHD yet as I seem to be handling the unique symptoms ok for now. I am finding that Tyrosine, EFAs( with added ginseng and DHEA), a multi Vitamin do wonders to help keep me focused and on task….most days..hahaha.

I have adhd ,ocd,dyspraxia,aspergers and depression.I feel like a freak.I hate reading about myself in the sense that I try to find more out about adhd and aspergers but it just …kinda males me feel like shit.I don’t like reading that compared to everybody else I have poor memory.It sucks.The thing that makes it worse is that I can see that it is trye when I go to work.Take my job for example; a puppet theatre.When we’re doing any task ,one rehersal of how we do it ( imagine we were doing a work shop ) is enough.Maybe the person helping us even does one rehersal the day before.So typically at work when you want a team of people to do something you might sit down for an hour to talk about it.Maybe you might even be able to act it out as you say your part.Except this isn’t even half of what I need to understand a task.I’m a kinesthetic learner and I have a great muscle memory ,but I will probably forgst everything you’ve just told me.I need to do something over and over again and or one on one to get it right without people waiting for me to catch up.This really upsets me.I’m 24 I should be better wt this.Its really hard not to compare myself to others.I get very disheartend when I make a mistake and I am very self critical.People ask me “ but why do you keep self abusing with this narrative in your head”.And.I have to explain that i do it for further punishment.I kind lf grew up thinking,if I can’t keep up, then I must be bad, then I must be guilty.The thing about guilt is this though.I have ocd too.Not bad but I have to be careful to keep it at bay.There are things I’m good at and I have excelled in.However I just seem to see the mistakes.I just wish I was me without these things.I actually feel guilty for my mum because her child could have been so much better.Like I always struggled in school and quite frankly didn’t get the education I deserved because I didn’t get the help I needed.It wasn’t until last year when I was 23 that I got diagnosed with adhd and aspergers withing the soace of two months.I really beleived my teachers thought i was stupid and if I cut myself ever these days (which is rare but happens ) its pretty much always because I think I’m stupid.This pains me so much because I love learning and reading and writing.I also have a lot of guikt because I had agoraphobia 3 times from the ages of 15-18 ( which is why i didn’t complete highschool. I feel unfulfilled and I feel so guilty.like everyday I feel guilty.And I’m sick of people saying “ hmm have you tried mindfulness”. I try to practice it regularly with the Calm app which I highly reccomend,but I don’t know if I beleive meditation can fully restore ones confidence or outlook.Because as I said…the problem is not that i do not know what to doto be kind to myself, the problem is that my brain tells itself that I do not deserve to change the pattern.
I must say though, being kinder to myself is a lot easier when ocd is low because I don’t get so much of that authoritive speaking to myself.It can be hard to tease apart not only where each of my disorders start and end but where my personality begins.

I am 57, and was diagnosed ADHD 6 months ago, frustrating that all those years could have been different by knowing. I do have some OCD, there are certain processes, and tasks, and placements of things that always have to be done. I am a very neat and tidy person. For me its the attention span, the work task and goals, and extreme hyperfocus, and memory. I have Alexa all over my house to remind of everything going on. If I could ever figure out how to use my hyperfocus for what I want and need to get done, it would be just amazing…but does not seem to work that way.

I have found that Zoloft at 100 to 150 mg each day in the morning (to avoid insomnia) helps with my OCD and depression. I am a perfectionist and I believe my OCD stems from that or quite possibly my perfectionism is a way to control my OCD. But anyhow, I still had trouble focusing and getting things accomplished. I added 25 mg of Strattera and it literally changed my life! It felt as if a cloud (mental fog that I didn’t even realize I was carrying around) was lifted. At first, I took 25 mg each day, but after it built up in my system, I realized through trial and error, that I did better taking 25 mg every other day. I take the Strattera at lunch time every other day to avoid side effects (such as sleepiness, if I take it at the same time as the Zoloft). I do not have any other side effects such as sexual performance, dizziness, etc. It was with a lot of research that I found the right combo for me. It is amazing!

I really appreciate this: “Another big difference between ADHD and OCD is chemical. ADHD is in part due to low dopamine levels in the brain and OCD is due in part to too much serotonin in the brain.” It’s succinct, and covers a whole lot of *why* in ‘don’t give THAT med’ discussions.

It never occurred to me in a million years that I may have ADHD. Despite my four year old being recently diagnosed. I knew ADHD was hereditary but his dr’s have always assured me that his ADHD is a result of sleep deprivation. However, after listening to Marcia Hoeck’s (how I found you) webinar Eat the Elephant a loud bell went off. I first listened to all of the podcasts on itunes and did more research. It all makes sense. My son (yes at 4) and I are both a little OCD. I can’t function with the slightest bit of clutter. However, if you open this bin I have you’ll find stacks of mail that have never been opened. I can’t make myself start a project no matter how important it is. I’ve been told I’m brilliant by others but yet, I’ve yet to reach my potential. Ahhh I could go on and on, but the reason this article really resonated was because, it never occurred to me that being hyper organized (mostly) was my way of trying to deal. My dad on the other hand is a mess. He’s 70 this year. I’m not sure how he’d take to me suggesting that he may have ADHD (all the other signs are there). What I’m hoping is that I’ll get help and he’ll see the marked improvement in me and then get help himself.

That sounds like a nightmare; I’m so sorry for your struggles. I hope things have gotten better since your post! I can empathize with the medication issues–I was misdiagnosed as bipolar (actually have depression with OCD and ADHD), and the mood-stabilizers and antipsychotics left me feeling like a total zombie.

It takes a while to figure out, but a combination of stimulant and SSRI is common for co-morbid ADHD and OCD. That being said, everyone will have different side effects and levels of tolerance. Only your doctor can tell you what’s best, but if you share your side effects I’m sure they can help you. Luvox is an SSRI and Vyvanse actually is a stimulant, but you have other options. There are two stimulant families–methylphenidate-based (Ritalin, for example) and amphetamine-based (Vyvanse is one of these). There are also non-stimulants, Strattera and Wellbutrin, that can help both ADHD and anxiety/depression. The tricky issue is that stimulants can sometimes worsen anxiety conditions like OCD. In my experience, SSRIs can also make ADHD worse because they can affect dopamine levels. But don’t give up hope! My experience with Celexa (an SSRI) combined with various stimulants has been increasingly good.

Help! I have both ADHD and OCD. I believe its the ocd causing the adhd but I could be wrong. Anyways they both run my life and when i was seeking treatment i felt my therapist and parent were just shoving whatever antipsychotic they could find down my throat. The meds they ultimately chose left me feeling blank and my mind totally numb. I was acting reckless at the time while taking Luvox and Vyvanse because i was so numb i couldnt differ what was irresponsible. At the same time addiction runs rabid in my family so i was perscribed “special” meds and in all honsty i feel that maybe a potentially habit forming stimulant may actually be what i need. Please im begging anyone out there who feels my frustration to please give me any advice they have. I wanna believe that i wont be prisoner to my mind forever.
Yours Truly,
Savannah A. Cunningham
Reno, NV

Hi Savannah. A lot of what you said resonated with me. I’ll briefly tell you my story so far and what I’ve found to be helpful and not so helpful.
I’m 30, was diagnosed with major clinical depression 2 years ago, although in hind sight i probably have had it for 10 years. 3 months ago was also given a possible dual diagnosis of adult ADHD and OCD.
There is also history in my family of addiction including myself.
I take 20mg of Ritalin a day, 100mg of Desvenlafaxine, force myself to walk the dog every morning, cold shower, lots of weed, meditation and seeing a good psychologist once every week or two. It’s tough because everyone is so different but I hope this helps a little. Good luck and remember not to be hard on yourself. Sending love your way xx

Hi Savannah,
I’m a 40 yr old woman dealing with what you’re dealing with. I actually had ECT for depression about 7 yrs ago which helped my depression beyond measure. I’m still stuck with ADD, OCD, and a really bad case of general anxiety disorder. I also have past addiction issues, so doctors are funny about what meds I can take. I’ve been having a really difficult time lately, and my therapist & psychiatrist haven’t been very helpful. My primary care doctor just suggested Strattera, so I’m going to call my psychiatrist and ask to try it again. I’ll let you know what happens and if it helps! I take 2400mg of Neurontin, 2.5 mg of Klonopin and Ambien for sleep! Hope you’re okay!

Hi savannah. I totally get where youre coming from. I have dual diagnosis ( which is adhd/ocd & addiction (which btw is actually the really dual diagnosis not being diagnosised with 2 thingd like the comment from someone else said) ) and have been clean for over 2 years now. Getting clean helped a lot, getting off adderrall helped a lot as well. Ill try to make this short. The adderral caused a flare up in my addictive nature and i ended up on actual drugs. So be cautious with stimulants. After i got clean i start AA and that helped me to start learning about myself and then lead me to take classes for adhd patients and helped teach me coping skills to learn to manage my adhd. I now only take proprenonolol, zoloft, and effexor. It helps a lot. I now manage and run a dog kennel so i feel i am living proof that anything can be overcome. Stay strong, get a support group that understands even if they are just online and see if there are classes you can take to help cope. But if you have had an addiction problem i would stay away from the amphetamines and man made amphetamines and maybe trying effexor. Which its persceibed for Adhd and ocd. Also weed helps. Good luck and if you need a support system look me up on fb. Leslie landers charlotte,nc i have purple hair.

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